Gemini Tanna,MD,FRCPC

Division of Nephrology,Department of Medicine

Sunnybrook Health SciencesCentre

AL GRAWANY

10 Editorial Toronto Notes 2023

Faculty Contributors,University of Toronto

SURGERY

Melissa Walker, MD,MSc,ERCSC

Abdollah Behzadi,MD,MBA, ERCSC FACS Staff Obstetrician Gynecologist, Department of

Division of Thoracic Surgery, Department of Surgery Obstetrics & Gynecology,Mount Sinai Hospital

Trillium Health Partners, University of Toronto

Sayf Gazala, MD.MSc,FRCSC

Assistant Professor,Thoracic Surgery Department of

Surgery;Michael Garron Hospital

GENERAL AND THORACIC SURGERY PLASTIC SURGERY

Joel Fish, MD, MSC, FRCS

Professor, Plastic and Reconstructive Surgery

Department of Surgery

The Hospital for Sick Children

Assistant Professor,Department of Obstetrics &

Gynecology;University of Toronto

OPHTHALMOLOGY

Asiin Ali, MD, FRCSC

Professor of Ophthalmology,University of Toronto

Ophthalmologist-in-Chief,The Hospital for Sick

Children

Siba Haykal,MD, PhD, FRCSC, FACS

Division of Plastic and Reconstructive Surgery,

Department of Surgery

Jesse Pasternak,MD,MPH,FRCSC University'Health Network

Section of EndocrineSurgeryDivision of General Surgery, Department of Surgery

University Health Network

UROLOGY

Monica Farcas,BEng, MEng, MD, FRCSC

Assistant Professor, Division of Urology

Department of Surgery, Unity I Iealth Toronto

Yonah Krakowsky, MD, FRCSC

Division of Urology

Womens College & Mount Sinai Hospital

Wai-Ching Lam, MD, FRCSC

Department of Ophthalmology and Vision Science

University Health Network,

Toronto Western Hospital

The Hospital for Sick Children

Fayez Quereshy,MD, MBA, FRCSC

Department of General Surgery

University Health Network.

Toronto Western

Hospital Jonathan Micicli, MD, FRCSC

Department of Ophthalmology and Vision Sciences;

Division of Neurology;Department of Medicine;

Kensington Vision and Research Centre,

St. Michaels Hospital, University of Toronto

GYNAECOLOGY

Michael Chaikof.MD,FRCSC,MS-HPEd

Division of Urogynecology

Department of OBGYN

Sunnybrook Health SciencesCentre

Jason Lee, MD.MHPE, FRCSC

Division of Urology;Department of Surgery

University Health Network. Toronto General

Hospital

ORTHOPAEDIC SURGERY

Jeremy Hall,MD, FRCSC

Division of Orthopaedic Surgery,Department of

Surgery;St. Michaels Hospital

Michael Ordon, MD,MSc,FRCSC

Division of Urology;Department of Surgery

SL Michael’s Hospital

Sari Kives,MD,FRCSC

Associate Professor

Division of Obstetrics and GynecologyDepartment of Obstetrics and Gynecology

St Michaels hospital

Paul Kuzyk, MD, MASc,FRCSC

Assistant Professor

Lower Extremity'Reconstruction SurgeryDivision of Orthopaedic Surgery

VASCULAR SURGERY

Elisa Greco,BSc, MEd, MD, RPYI, FRCSC

Vascular Surgeon, St Michaels Hospital

NEUROSURGERY

Sunit Das,MD, PhD

Division of Neurosurgery

St.Michaels Hospital

George Oreopoulos, MD, MSc, FRCSC

Division of Vascular Surgery,

Department of Surgery

University Health Network

Jesse Wolfstadt, MD, MSc, FRCSC

Granovsky Gluskin Division of Orthopaedic Surgery,

Department of Surgery,Sinai 1Iealth Sy stem

Michael G.Fehlings, MD. PhD, FRCSC, FACS

Professor of Neurosurgery;Department of Surgery;

University ofToronto

Vice Chair Research,Department of Surgery;

University of Toronto

Senior Scientist, Krembil Brain Institute,

University Health Network

Staff Neurosurgeon,University- Health Network

Co-Director,University of Toronto Spine Program

OTOLARYNGOLOGY

Yvonne Chan, MD, MSc, FRCSC

Otolaryngologist-in-chief,

St. Michael’

s Hospital, Unity Health

Associate Professor and Continuing Professional

Development Director

Department of Otolaryngology -

Head & Neck Surgery

Antoine Eskandcr,MD,ScM, FRCSC

Assistant Professor

Department of Otolaryngology -

Ilead & Neck Surgery

Sunnybrook Health SciencesCentre,

Odette Cancer Centre

Michael Garron Hospital

Eric M.Massicotte MIX MSc,MBA, FRCSC

Associate Professor University of Toronto

Staff Neurosurgeon,University Health Network

Medical Director,Back & Neck Program Altum

Health

OBSTETRICS

Richard Pittini, MD, MEd. FRCSC, FAC.OG

Department of Obstetrics and Gynecology;

University of Toronto

Sunnybrook I Iealth SciencesCentre

Jonathan Irish, MD, MSc, FRCSC

Department of Otolaryngology,

l lead and Neck Surgery,

University Health Network

Mara Sobel, MD, MSc.FRCSC

Department of Obstetrics and Gynecology;

University- of Toronto

Mount Sinai Hospital University Health Network,

Toronto General Hospital,Womens College Hospital

+

11 Editorial Toronto Notes 2023

Table of Contents

Index Abbreviations

Common Acronyms and Abbreviations Used in Medicine

Common Unit Conversions

Commonly Measured Laboratory Values

Ethical, Legal, and Organizational Medicine

Anesthesia

ELOM

A

Cardiology and Cardiac Surgery.

Clinical Pharmacology

Dermatology

Emergency Medicine

Endocrinology

Family Medicine

Gastroenterology

General and Thoracic Surgery . .

Geriatric Medicine

C

CP

D

ER

E

FM

G

GS

GM

Gynaecology

Hematology

Infectious Diseases

GY

H

ID

Medical Genetics MG

Medical Imaging

Nephrology

Neurology

Neurosurgery...

Obstetrics

Ml

NP

N

NS

OB

Ophthalmology OP

Orthopaedic Surgery OR

Otolaryngology OT

Paediatrics P

Palliative Medicine PM

Plastic Surgery

Psychiatry

Public Health and Preventive Medicine

PL

PS

PH

Respirology

Rheumatology ..

Urology

Vascular Surgery

R ri

L J

RH

U

VS +

AL GRAWANY

12 Editorial Toronto Notes 2023

How To Use This Book

This book has been designed to remain as one book or to be taken apart into smaller booklets.Identify the beginning and end

of a particular section, then carefully bend the pages along the perforated line next to the spine of the book.Then tear the pages

out along the perforation.

The layout of Toronto Notes allows easy identification of important information.

These items are indicated by icons interspersed throughout the text:

Icon Icon Name Significance

This icon is found next to headings in the text.It identities key objectives and conditions as

determined by the Medical Council of Canada or the National Board of Medical Examiners

in the USA.If it appears beside a dark title bar, allsubsequentsubheadingsshould be S considered key topics.

Key Objectives

This icon isfound in sidebars of the text.It identifies concise,important information which

will aid in the diagnosis or management of conditions discussed in the accompanying text.

Clinical Pearl

This icon isfound in sidebars of the text.It identifies helpful mnemonic devices and other

memory aids.

Memory Aid

(§)

This icon isfound in sidebars of the text.It indicatesinformation or findings that require

urgent management orspecialist referral.

Clinical Flag

This icon isfound in sidebars ofthe text.It identifies key research studiesfor evidencebased clinical decision making related to topics discussed in the accompanying text.

Evidence Based Medicine

This icon isfound next to headingsin the text.It indicatestopics that correspond with Wi imagesfound in theColour Photo Atlas available online (www.torontonotes.ca).

Colour Photo Atlas

This icon isfound next to headings in the text.It indicates topics that correspond to images EH found in the Radiology Atlas available online (www.torontonotes.ca).

Radiology Atlas

This icon isfound next to headingsin the text.It indicates topics that correspond with

electronic resourcessuch as Functional Neuroanatomy or ECGs Made Simple, available S online (www.torontonotes.ca).

Online Resources

Chapter Divisions

To aid in studying and finding relevant material quickly, many chapters incorporate the following general framework:

Basic Anatomy/Physiology Review

• features the high-yield,salient background information students are often assumed to have remembered from their early medical school

education

Common Differential Diagnoses

• aims to outline a clinically useful framework to tackle the common presentations and problemsfaced in the area of expertise

Diagnoses

• the bulk of the book

• etiology, epidemiology, pathophysiology, clinical features,

investigations, management, complications, and prognosis r “i

L J

Common Medications

• a quick reference section for review of medications commonly prescribed +

13 Editorial Toronto Notes 2023

Common Acronyms and Abbreviations Used in

Medicine

The following are common medical acronyms/abbreviations that may be used without definition throughout the Toronto

Notes text. These are typically not included in the acronym list at the beginning of each chapter. Please refer back to this

list for definitions.

U electrocardiogram

emergency department

electroencephalography

electromyography

cars, nose, and throat

erythrocyte sedimentation rate

cthanol/alcohol

concentration ECC,

p-hCG beta human chorionic gonadotropin ED

EEC

ABx antibiotics

angiotensin-converting enzyme

Adrenocorticotropic hormone

acquired immune deficiency syndrome

alkaline phosphatase

alanine aminotransferase

absolute risk

acetylsalicylic acid

aspartate transaminase

asymptomatic

abdominal x-ray

EMC.

ACE ENT

ACTH

AIDS

ESR

EtOH

ALP

family medical history

follicle stimulating hormone

ALT FMHx

AR FSH

ASA

glucosc-6-phosphate dehydrogenase

gamma-glutamyl transferase

growth hormone

gamma hydroxybutyrate

gastrointestinal

genitourinary

AST G6PD

aSx GG.T

AXR GH

GHB

twice a day (bis in die)

body mass index

blood pressure

BPM/bpm beats per minute

BID GI

BMI GU

BP

hemoglobin

human immunodeficiency disease

heart rate

hypertension

history

Hb

HIV

C/I contraindication

culture and sensitivity

coronary artery disease

complete blood count

chief complaint

congestive heart failure

chronic obstructive pulmonary disease

cardiopulmonary resuscitation

creatinine

corticotropin-releasing hormone

cerebrospinal fluid

computed tomography

chest x-ray

HR

C&S HTN

CAD Hx

CBC

CC I&D incision and drainage

intracranial pressure

intensive care unit

intramuscular

intravenous

CHF ICP

COPD ICU

CPR IM

Cr IV

CRH

CSF JVP jugular venous pressure

CT

lactate dehydrogenase

liver function test

luteinizing hormone

likelihood ratio

CXR LDH

LFT

D&C dilatation and curettage

diastolic blood pressure

differential diagnosis

diabetes mcllitus

do not resuscitate

diagnosis

LH r

dBP LR

DDx

DM +

DNR

Dx

AL GRAWANY

H Editorial Toronto Notes 2023

Common Acronyms and Abbreviations Used in

Medicine

monoamine oxidase

monoamine oxidase inhibitor

metered-dose inhaler

myocardial infarction

magnetic resonance imaging

musculoskeletal

systolic blood pressure

subcutaneous

sublingual

systemic lupus erythematosus

shortness of breath

urgent or immediately (statum)

sexually transmitted infection

symptom(s)

MAO

MAOI

sBP

SC

MDI SL

MI SLE

MRI SOB

MSK STAT

STI

N/V nausea/vomiting

nasogastric

N-Mcthyl-D-aspartate

nothing by mouth (nil per os)

non-steroidal anti-inflammatory drug

Sx

NG

TlDM

T2DM

type 1 diabetes mellitus

type 2 diabetes mellitus

tuberculosis

three times a day (ter in die)

tumour, nodes, and metastases

thyroid releasing hormone

thyroid stimulating hormone

treatment

NMDA

NPO

NSAID TB

TID

OR operating room TNM

OTC over-die-counter TRH

TSH

PCR polymerase chain reaction

pulmonary embolism

past medical history

oral administration (per os)

point-of-care ultrasound

proton pump inhibitor

as needed ( pro re nata)

Tx

PE

PMHx U/A urinalysis

ultrasound

urinary tract infection

urine toxicology screen

PO U/S

POCUS UTI

PPI UTox

PRN

VDRL Venereal Disease Research Laboratory test

QID four times a day (quatcr in die)

WBC white blood cell

red blood cell weight

randomized controlled trial

review of symptoms

medical prescription

RBC wt

RCT

ROS

Rx

pi

+

15 Editorial Toronto Notes 2023

Common Unit Conversions

To convert from the conventional unit to the SI unit,multiply by conversion factor

To convert from the SI unit to the conventional unit,divide by conversion factor

Conventional Unit Conversion Factor SI Unit

ACTH pg/mL 0.22 pmol/L

Albumin g/dL 10 g/L

Bilirubin mg/dL 17.1 pmol/L

Calcium mg/dL 0.25 mmol/L

Cholesterol mg/dL 0.0259 mmol/L

Cortisol pg/dL 27.59 nmol/L

Creatinine mg/dL 88.4 pmol/L

Creatinine clearance mL/min 0.0167 mL/s

Ethanol mg/dL 0.217 mmol/L

Ferritin ng/mL 2.247 pmol/L

Glucose mg/dL 0.0555 mmol/L

HbA1c % 0.01 proportion of 1.0

Hemaglobin g/dL 10 g/L

HDL cholesterol mg/dL 0.0259 mmol/L

Iron,total pg/dL 0.179 pmol/L

Lactate (lactic acid) mg/dL 0.111 mmol/L

LDL cholesterol mg/dL 0.0259 mmol/L

x lO^

ells/mm 3 Leukocytes 1 x 109cells/L

Magnesium mg/dL 0.411 mmol/L

MCV pm3 1 fL

x lO^

Platelets ells/mm 3 1 x 109cells/L

Reticulocytes % of RBCs 0.01 proportion of 1.0

Salicylate mg/L 0.00724 mmol/L

Testosterone ng/dL 0.0347 nmol/L

Thyroxine (T4) ng/dL 12.87 pmol/L

Total Iron Binding Capacity pg/dL 0.179 pmol/L

Triiodothyronine (T3) pg/dL 0.0154 pmol/L

Triglycerides mg/dL 0.0113 mmol/L

Urea nitrogen mg/dL 0.357 mmol/L

Uric acid mg/dL 59.48 pmol/L

Celsius •

*

Fahrenheit F = (C x 1.8) + 32 r

L J

Fahrenheit Celsius C = (F - 32) x 0.5555

Kilograms •

*

Pounds 1 kg = 2.2 lbs

Pounds Ounces 1 lb = 16 oz +

Ounces •

*

Grams 1 oz = 28.3 g

Inches •

*

Centimetres 1 in = 2.54 cm

AL GRAWANY

16 Editorial Toronto Notes 2023

Commonly Measured Laboratory Values

Test Conventional Units SI Units

Arterial Blood Gases

7.35-7.45

35-45 mmHg

80-105 mmHg

7.35-7.45

4.7-6.0 kPa

10.6-14 kPa

pH

PC02

PO2

Serum Electrolytes

Bicarbonate

Calcium

Chloride

Magnesium

Phosphate

Potassium

Sodium

22-28 mEq/L

8.4-10.2 mg/dL

95-106 mEq/L

1.3-2.1 mEq/L

27-4.5 mg/dL

3.5-5.0 mEq/L

136-145 mEq/L

22-28 mmol/L

2.1-2.5 mmol/L

95-106 mmol/L

0.65-1.05 mmol/L

0.87-1.45 mmol/L

3.5-5.0 mmol/L

136-145 mmol/L

Serum Nonelectrolytes

Albumin

ALP

ALT

Amylase

AST

Bilirubin (direct)

Bilirubin (total)

BUN

Cholesterol

Creatinine (female)

Creatinine (male)

Creatine Kinase - MB fraction

Ferritin (female)

Ferritin (male)

Glucose (fasting)

HbA1c

LDH

Osmolality

3.5-5.0 g/dL

35-100 U/L

8-20 U/L

25-125 U/L

8-20 U/L

0-0.3 mg/dL

0.1-1.0 mg/dL

7-18 mg/dL

<200 mg/dL

10-70 U/L

25-90 U/L

0-12 U/L

35-50 g/L

35-100 U/L

8-20 U/L

25-125 U/L

8-20 U/L

0-5 pmol/L

2-17 pmol/L

2.5-7.1 mmol/L

<5.2 mmol/L

10-70 U/L

25-90 U/L

0-12 U/L

12-150 pg/L

15-200 pg/L

3.8-6.1 mmol/L

<0.06

100-250 U/L

275-300 mOsm/kg

12-150 ng/mL

15-200 ng/mL

70-110 mg/dL

<6%

100-250 U/L

275-300 mOsm/kg

Serum Hormones

ACTH (0800h)

Cortisol (0800h)

Prolactin

Testosterone (male,free)

Thyroxine (T4)

Triiodothyronine (T3)

TSH

<13.2 pmol/L

138-635 nmol/L

<20 ng/mL

0.31-1 pmol/L

64-155 nmol/L

1.8-2.9 nmol/L

0.5-5 pU/mL

<60 pg/mL

5-23 pg/dL

<20 ng/mL

9-30 ng/dL

5-12 ng/dL

115-190 ng/dL

0.5-5 pU/mL

Hematologic Values

ESR (female)

ESR (male)

Hemoglobin (female)

Hemoglobin (male)

Hematocrit (female)

Hematocrit (male)

0-20 mm/h

0-15 mm/h

12.3-15.7 g/dL

13.5-17.5 g/dL

36-46%

41-53%

1.0-1.1

4.5-11 x 103cells/mm 3

88-100 pm 3

150-400 x 103/mm3

25-35 s

0.5-15% of RBC

0-20 mm/h

0-15 mm/h

123-157 g/L

140-174 g/L

36-46%

41-53%

10-1.1

4.5-11 x 109cells/L

88-100 fL

150-400 X 109/L

25-35 s

20-84 x 109/L

r "> \

1 <-

J J

INR

Leukocytes

MCV

Platelets

PTT

Reticulocytes

+

ELOM Ethical,Legal, and Organizational Medicine

Konya Costa-Dookhan and Zuhal Mohmand, chapter editors

Ming Li and Dorrin Zarrin Khat, associate editors

Vijithan Sugumar, EBM editor

Dr.Andria Bianchi, Dr. Nadia Incardona, and Dr.Chase McMurren,staff editors

Acronyms EL0M2

The Canadian Healthcare System.

Overview of the Canadian Healthcare System

Legal Foundation

History of the Canadian Healthcare System and CrownIndigenous Relations Pursuant to Healthcare

Healthcare Expenditure and Delivery in Canada

Physician Licensure and Certification

Role of Professional Associations

Ethical and Legal Issues in Canadian Medicine

Introduction to the Principles of Ethics

Confidentiality

Consent and Capacity

Negligence

Truth-Telling

Ethical Issues in Health Care

Reproductive Technologies

End-of-Life Care

Physician Competence and Professional Conduct

Research Ethics

Physician-Industry Relations

Resource Allocation

Conscientious Objection

Clinical Informatics and Ethical Considerations

Key Terms

Overview of Digital Health Technologies

Indigenous Health

Overview of the History and Impact of Colonialism

Movement Towards Reconciliation

Indigenous Disproportionate Over-Representation of Biological,

Psychological, and Social Co-Morbidities

Indigenous Health Coverage and Jurisdictions

Resources in Indigenous Health

References.

EL0M2

ELOM8

ELOM23

ELOM24

ELOM31

further information on these topics can be found in the Objectives of the Considerations of the Legal, Ethical, and

Organizational Aspects of the Practice of Medicine (CLEO) - which can be downloaded free of charge from the Medical

Council of Canada website at http://mcc.ca/wp-content/uploads/CLEO.pdf.

There are three main types of law in Canada: criminal, civil, and administrative. The penalties for violating each are,

in general, as follows: criminal-fine or incarceration;civil- monetary damages paid to the wronged party; and

administrative - sanctions by the regulator (such as a suspension by the College of Physicians and Surgeons). All three

types of law can be engaged by a single act. l or example, a physician that inappropriately touches a patient can be liable

for criminal (sexual assault), civil (monetary'damages paid to the patient for the civil wrong of sexual assault), and

administrative (fines and sanctions up to and including loss of ability to practice medicine for sexual abuse) penalties.

Canadian law applicable to medical practice varies between jurisdictions and changes over time.

r n

L J

+ Criminal law is nationwide, but civil and administrative law varies between provinces and territories. This section is meant

to serve only as a guide.Students and physiciansshould ensure that their practices conform to local and current laws.

EL0M1 Ethical, Legal, and Organizational Medicine Toronto Notes 2023

AL GRAWANY

EL0M2 Ethical, Legal, and Organizational Medicine Toronto Notes 2023

Acronyms

CPSO College of Physicians and

Surgeons of Ontario

electronic medicalrecord

IMCC Licentiate of the Medical Council PTMA

of Canada

MAID Medical Assistance in Dying

MCC Medical Council of Canada

OECD Organization for Economic Co- RDoC

operation and Development

OMA Ontario Medical Association

OTC over the counter

PHO Provincial House staff

Organization

PIPEDA Personal Information Protection

and Electronic Documents Act

POA Power of Attorney

Provincial/Territorial Medical

Association

RCPSC Royal College of Physicians and

Surgeons of Canada

Resident Doctors of Canada

SOM substitute decision-maker

IRC Truth and Reconciliation

Commission

AE adverse event

assisted reproductive

technologies

Canadian Federation of Medical FMEO

Students

ART

EMR

Federation medicale etudiante

du Quebec

CFPC College of Family Physicians of FRCPC Fellow of the Royal College of

Canada

CIHR Canadian Institutes of Health

CFMS

Physicians of Canada

FRCSC Fellow of the Royal College of

Surgeons of Canada

GA gestational age

GDP gross domestic product

HCCA Health Care Consent Act

IVF in vitro fertilization

Research

CMA Canadian Medical Association

CME continuing medical education

CMPA Canadian Medical Protective

Association

The Canadian Healthcare System

Overview of the Canadian Healthcare System

• one federal, three territorial, and ten provincial systems

• major complexities in establishment of Canadian health policy include geographical diversity,

socioeconomic divisions, and international pressures

• financed by both the public (70%) and private (30%) sectors

• each provincial/territorial plan must cover all medically necessary health services and remain in

compliance with the Canada Health Act in order to receive federal transfers

• provincial/territorial governments may choose to offer and fund supplementary services not covered

under the Canada Health Act,such as prescription drugs and vision care

• non-insured health services and fees are either covered by private insurance or by the individual

• workers’ compensation funds cover treatment for work-related injuries and diseases

Table 1. Division of Government Responsibilities in Healthcare

Principles of the Canada Health Act

1. Public Administration:provincial/

territorial health insurance programs

must be administered on a not-forprofit basis by public authorities

2. Comprehensiveness: provincial/

territorial health insurance programs

must cover all medically necessary

diagnostic,physician,and hospital

services

3. Universality:all eligible residents

must be entitled to healthcare

services (including status First

Nations peoples and Inuit:note

that non-status First Nations and

Metis are included under all eligible

residents)

4. Portability:emergency health

services must be available to

Canadians who are outside their

home province, paid for by the home

province

5. Accessibility: provincial/territorial

plans must ensure reasonable access

to medically necessary hospital and

physician services without financial

or other barriers

Federal Government Provincial Government

Healthcare services for Indigenous peoples (Status First Nations

peoples and Inuit only,Non-Insured Health Benefits (NIHB)),federal

government employees (RCMP and armed tones),immigrants,and civil

aviation personnel

Marine hospitals and quarantine (Constitution Ad, 186?)

Investigations into public health

Regulation ol food and drugs

Inspection of medicaldevices

Administration of healthcare insurance

General information services related to healthconditions and practices

Role inhealth derives from constitutional responsibility over criminal

law.spending powers,and legislation for 'peace,order, and good

government.’Examples include CanadaHealthAct,Food and DrugsAct.

ControlledSubstancesAct, and Canada Health IransferAct)

Establishment,maintenance,and management of hospitals,asylums,

charities,and charitable institutions {ConstitutionAct,1867)

licensing of physicians,nurses,and other hcallli professionals

Determining the standards for licensing all hospitals

Administering provincial medical insurance plans

Financing healthcare facilities

Delivery of certain public health services

Legal Foundation

• the legal foundation of the Canadian health system is based on:

• five constitutional documents:

1. Royal Proclamation (1763): the foundation for the rights of Indigenous peoples in Canada;

sets out the sovereignty of Indigenous peoples in Canada

2. Constitution Act (1867): deals primarily with the jurisdictional power between federal and

provincial governments

3. Treaty 6 (1876):included the Medicine Chest Clause,svhich addresses Indigenoussovereignty

in healthcare delivery and equitable access to all forms of medicine

4. Dreavervs. King court ruling (1935): provided the legal precedence for Non-Insured Health

Benefits

5. The Canadian Charter of Rights and f reedoms (1982): does not guarantee a right to

healthcare; but, if the government decides to finance healthcare, they are constitutionally

obliged to do so consistently with the rights and freedoms outlined in the Charter (including

the right to equality, physicians’ mobility rights, etc.)

two statutes:

I. Canada Health Act (1984): outlines the national terms and conditions that provincial health

systems must meet in order to receive federal transfer payments

The federal government can reduce its

contributions to provinces that violate

the key principles of the Canada Health

Act

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+